Utyando lwentliziyo evulekileyo

Umxholo

• Lufuneka nini utyando lwentliziyo evulekileyo?
• Yenziwa njani utyando lwentliziyo evulekileyo?
• Buphi ubungozi botyando lwentliziyo oluvulekileyo?
• Uyilungiselela njani into yotyando lwentliziyo evulekileyo
• Kwenzeka ntoni emva kotyando lwentliziyo evulekileyo?
• Ukufumana kwakhona, ukulandelela, kunye nento onokuyilindela
• Ukunyamekela
• Ulawulo lweentlungu
• Lala ngokwaneleyo
• Ukubuyisela kwisimo sangaphambili
• Umbono wexesha elide lotyando lwentliziyo oluvulekileyo

Ushwankathelo

Utyando lwentliziyo evulekileyo lulo naluphi na uhlobo lotyando apho isifuba sinqunyulwa sivuliwe kwaye uqhaqho lwenziwa kwimisipha, kwiivelufa okanye kwimithambo yentliziyo.

Ngokwe-coronary artery bypass grafting (CABG) lolona hlobo luqhelekileyo lotyando lwentliziyo olwenziwe kubantu abadala. Ngexesha lotyando, umthambo osempilweni okanye umthambo uyamiliselwa (uqhotyoshelwe) kumthambo we-coronary ovaliweyo. Oku kuvumela umthambo omiliselweyo ukuba "ugqithe" umthambo ovalelweyo kwaye uzise igazi elitsha entliziyweni.

Utyando lwentliziyo evulekileyo ngamanye amaxesha lubizwa ngokuba luqhaqho lwentliziyo oluqhelekileyo. Namhlanje, iinkqubo ezininzi ezintsha zentliziyo zinokwenziwa ngokucheba nje okuncinci, hayi ukuvuleka okubanzi. Ke ngoko, igama elithi "utyando lwentliziyo evulekileyo" linokulahlekisa.

Lufuneka nini utyando lwentliziyo evulekileyo?

Utyando lwentliziyo evulekileyo lunokwenziwa ukwenza iCABG. Umthambo wecoronary bypass weqhekeza kunokuba yimfuneko kubantu abanesifo sentliziyo.

Isifo sentliziyo esivela eCoronary senzeka xa imithambo yegazi ebonelela ngegazi kunye neoksijini kwisisipha sentliziyo iba mxinwa kwaye ibenzima. Oku kudla ngokubizwa ngokuba "lukhuni kwemithambo."

Ukuqina kuyenzeka xa izinto ezinamafutha zakha i-plaque kwiindonga zemithambo yegazi. Olu cwecwe luyayicutha imithambo, nto leyo eyenza kube nzima ukuba igazi liphume. Xa igazi lingenako ukuhamba kakuhle entliziyweni, isifo sentliziyo sinokubakho.

Utyando lwentliziyo evulekileyo luyenziwa kwakhona:

• lungisa okanye ubeke endaweni iivevithi zentliziyo, ezivumela igazi ukuba lihambe entliziyweni
• lungisa iindawo ezonakalisiweyo okanye ezingaqhelekanga zentliziyo
• Ukufakela izixhobo zonyango ezinceda intliziyo ibethe kakuhle
• buyisela intliziyo eyonakeleyo ngentliziyo enikelweyo (ukufakelwa kwentliziyo)

Yenziwa njani utyando lwentliziyo evulekileyo?

Ngokwe, i-CABG ithatha ukusuka kwiiyure ezintathu ukuya kwezintandathu. Yenziwa ngokubanzi kulandela la manyathelo asisiseko:

• Isigulana sinikwa i-anesthesia ngokubanzi. Oku kuqinisekisa ukuba baya kulala kwaye iintlungu zikhululekile kulo lonke utyando.
• Ugqirha wenza i-8- ukuya kwe-10-intshi ukusika esifubeni.
• Ugqirha usika lonke okanye inxalenye yesifuba sesigulana ukuze abhence intliziyo.
• Nje ukuba intliziyo ibonakale, isigulana sinokudityaniswa kumatshini wokudlula kwentliziyo-nemiphunga. Lo matshini ushenxisa igazi lisuka entliziyweni ukuze ugqirha akwazi ukusebenza. Ezinye iinkqubo ezintsha azisebenzisi lo matshini.
• Ugqirha usebenzisa umthambo osempilweni okanye umthambo ukwenza indlela entsha ejikeleze umthambo ovaliweyo.
• Ugqirha uluvala uvalo lwesifuba ngocingo, eshiya ucingo ngaphakathi emzimbeni.
• Ukunqunyulwa koqobo kuthungisiwe.

Ngamanye amaxesha ukwenziwa okungqongqo kwenzelwa abantu abasemngciphekweni omkhulu, njengaleyo yoqhaqho oluninzi okanye abantu abalupheleyo. Ukucwangciswa kwangaphandle kuxa isifuba siphinda sidityaniswa kunye neepleyiti ezincinci zetitanium emva kotyando.

Buphi ubungozi botyando lwentliziyo oluvulekileyo?

Ingozi yotyando lwentliziyo evulekileyo zibandakanya:

• usulelo lwenxeba lwesifuba (oluqheleke kakhulu kwizigulana ezinokutyeba kakhulu okanye isifo seswekile, okanye abo bebekhe banayo i-CABG ngaphambili)
• isifo sentliziyo okanye ukubetha
• ukubetha kwentliziyo ngokungaqhelekanga
• ukusilela kwemiphunga okanye kwezintso
• iintlungu esifubeni kunye nomkhuhlane ophantsi
• ukulahleka kwememori okanye "ukungazinzi"
• ihlwili legazi
• ukopha
• ubunzima bokuphefumla
• ukukrala kwemiphunga

NgokweZiko leNtliziyo kunye neVascular kwiYunivesithi yaseChicago Medicine, umatshini wokudlula kwentliziyo nemiphunga unxulunyaniswa nomngcipheko owandayo. Obu bungozi kubandakanya ukubetha kunye neengxaki zemithambo-luvo.

Uyilungiselela njani into yotyando lwentliziyo evulekileyo

Tshela ugqirha wakho malunga naziphi na iziyobisi ozithathayo, nokuba ungathengisa amayeza, iivithamini kunye namayeza. Bazise ngazo naziphi na izifo onazo, kubandakanya ukuvela kweherpes, ukubanda, umkhuhlane, okanye umkhuhlane.

Kwiiveki ezimbini ngaphambi kotyando, ugqirha wakho unokukucela ukuba uyeke ukutshaya kwaye uyeke ukuthatha amayeza okucoca igazi, njengeasprini, ibuprofen, okanye naproxen.

Kubalulekile ukuba uthethe nogqirha wakho malunga nokusela kwakho utywala ngaphambi kokuba ulungiselele utyando. Ukuba uneziphuzo ezintathu okanye nangaphezulu ngemini kwaye uyeke kanye phambi kokuba ungene kotyando, ungangena ekuyekeni kotywala. Oku kunokubangela iingxaki ezisongela ubomi emva kotyando lwentliziyo oluvulekileyo, kubandakanya ukuxhuzula okanye ukungcangcazela.Ugqirha wakho unokukunceda ekurhoxiseni utywala ukunciphisa amathuba ezi ngxaki.

Kusuku olungaphambi kokwenziwa kotyando, unokucelwa ukuba uzihlambe ngesepha ekhethekileyo. Le sepha isetyenziselwa ukubulala iintsholongwane kulusu lwakho kwaye iya kunciphisa ithuba losulelo emva kotyando. Unokucelwa ukuba ungatyi okanye usele nantoni na emva kobusuku.

Umboneleli wakho wezempilo uya kukunika imiyalelo eneenkcukacha xa ufika esibhedlele ngotyando.

Kwenzeka ntoni emva kotyando lwentliziyo evulekileyo?

Xa uvuka emva kotyando, uya kuba neetyhubhu ezimbini okanye ezintathu esifubeni sakho. Oku kukunceda ukukhupha ulwelo kwindawo ejikeleze intliziyo yakho. Unokuba nemigca efakwa ngaphakathi (IV) engalweni yakho ukuze ubonelele ulwelo, kunye necatheter (ityhubhu ebhityileyo) kwisinyi sakho ukususa umchamo.

Uyakuncanyathiselwa koomatshini abajonga intliziyo yakho. Abongikazi baya kuba kufutshane ukukunceda xa kukho into enokuvela.

Uhlala uchitha ubusuku bakho bokuqala kwigumbi labagula kakhulu (i-ICU). Uya kusiwa kwigumbi lokunyamekela rhoqo kwiintsuku ezintathu ukuya kwezi sixhenxe zilandelayo.

Ukufumana kwakhona, ukulandelela, kunye nento onokuyilindela

Ukuzikhathalela ekhaya ngokukhawuleza emva kotyando yinxalenye ebalulekileyo yokuchacha.

Ukunyamekela

Unonophelo lwento ebaluleke kakhulu. Gcina indawo yakho yokusika ifudumele kwaye yomile, kwaye hlamba izandla zakho ngaphambi nasemva kokuyichukumisa. Ukuba i-incision yakho iphilisa ngokufanelekileyo kwaye akukho dreyina, ungahlamba. Ishawa akufuneki ibe ngaphezulu kwemizuzu eli-10 ngamanzi ashushu (hayi ashushu). Kuya kufuneka uqiniseke ukuba indawo yokusika ayibethi ngqo emanzini. Kwakhona kubalulekile ukuba uhlolisise rhoqo iisayithi zakho zokusika iimpawu zentsholongwane, ezibandakanya:

• ukwanda kwamanzi, ukukhupha, okanye ukuvula kwindawo yokuqhawula
• ubomvu obujikeleze ukusikwa
• ukufudumala ecaleni komgca wokusika
• ifiva

Ulawulo lweentlungu

Ulawulo lweentlungu lukwabaluleke kakhulu, njengoko lunokunyusa isantya sokubuyisa kunye nokunciphisa ukubakho kweengxaki ezinje ngegazi okanye inyumoniya. Unokuziva iintlungu zemisipha, iintlungu zomqala, iintlungu kwiindawo zokucheba, okanye iintlungu kwiityhubhu zesifuba. Ugqirha wakho uya kukunika amayeza eentlungu onokuzithatha ekhaya. Kubalulekile ukuba uyithathe njengoko kumiselwe. Abanye oogqirha bancomela ukuthatha amayeza eentlungu ngaphambi kokuzilolonga nangaphambi kokuba ulale.

Lala ngokwaneleyo

Ezinye izigulana zinengxaki yokulala emva kotyando lwentliziyo evulekileyo, kodwa kubalulekile ukuba ufumane ukuphumla kangangoko. Ukuze ulale ngcono, unga:

• thatha amayeza entlungu kwisiqingatha seyure ngaphambi kokuba ulale
• lungiselela iipilo ukunciphisa izihlunu
• thintela i-caffeine, ngakumbi ngokuhlwa

Kwixesha elidlulileyo, abanye baye bathi utyando lwentliziyo evulekileyo lukhokelela ekwehleni kokusebenza kwengqondo. Nangona kunjalo, uphando olutshanje lufumene ukuba akunjalo. Nangona ezinye izigulana zinokuthi zenze utyando lwentliziyo evulekileyo kwaye namava okwehla kwengqondo kamva, kucingelwa ukuba oku kunokwenzeka kakhulu ngenxa yendalo yokuguga.

Abanye abantu banamava oxinzelelo okanye uxinzelelo emva kotyando lwentliziyo oluvulekileyo. Umgqirha okanye ugqirha wengqondo unokukunceda ulawule ezi ziphumo.

Ukubuyisela kwisimo sangaphambili

Uninzi lwabantu abaye banenzuzo yeCABG ngokuthatha inxaxheba kwinkqubo yolungelelwaniso, ebanzi. Oku kuhlala kwenziwa ngaphandle kokundwendwela amatyeli aliqela ngeveki. Izinto ezikwinkqubo zibandakanya ukuzilolonga, ukunciphisa umngcipheko, kunye nokujongana noxinzelelo, uxinzelelo kunye noxinzelelo.

Umbono wexesha elide lotyando lwentliziyo oluvulekileyo

Lindela ukuchacha ngokuthe ngcembe. Kungathatha ukuya kwiiveki ezintandathu ngaphambi kokuba uqale uzive ungcono, kwaye ukuya kuthi ga kwiinyanga ezintandathu ukuziva izibonelelo ezipheleleyo zotyando. Nangona kunjalo, umbono ulungile kubantu abaninzi, kwaye iigrafti zinokusebenza iminyaka emininzi.

Nangona kunjalo, utyando aluthinteli ukubhloka kwemithambo ukuba ingenzeki kwakhona. Unganceda ukuphucula impilo yentliziyo yakho ngoku:

• ukutya ukutya okusempilweni
• ukunciphisa ukutya okunetyuwa eninzi, amanqatha neswekile
• ekhokelela kwindlela yokuphila esebenzayo
• engatshayi
• ukulawula uxinzelelo lwegazi oluphezulu kunye ne-cholesterol ephezulu